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Background: To study the association of ocular biometric parameters {Spherical equivalent (SE), Axial length (AL), Anterior chamber depth (ACD) and Corneal curvature (CC)} with diabetic retinopathy (DR) in subjects with Type 2 diabetes mellitus (DM).Methods: This prospective observational study was conducted in the Outpatient Department of Ophthalmology of a tertiary care teaching hospital in North India. The study included 100 subjects having various grades of DR as cases and 100 diabetics without DR as controls. The SE was assessed using objective autorefraction, while AL, CC and ACD were measured using the NIDEK AL SCAN. International Clinical Diabetic Retinopathy Disease Severity Scale was used for grading of DR.Results: A total of 181 eyes in the study group and 200 eyes in the control group were analysed. Progressive decrease in the mean AL was observed with the increasing severity of DR (p=0.017). Deeper ACD had a negative correlation with severity of DR (p=0.037). No statistically significant difference was observed for AL and ACD with the incidence of DR (p=0.147 and p=0.091 respectively). Likewise, there was no significant relation of DR with SE or CC.Conclusions: Longer AL and deep ACD were protective against progression to the severe forms of DR. However, there was no correlation of AL and ACD with the incidence of DR. The SE and CC were not found to be significant determinants for either development or severity of DR.
RESUMO
Context: Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. Aims: This study evaluates the spectrum of ocular manifestations in acute and chronic leukemias presenting to a tertiary care center in India. Settings and Design: Subjects of leukemia presenting to a tertiary care center in India. Subjects and Methods: A prospective, cross‑sectional study looking at the spectrum of ocular manifestations in all inpatients of acute or chronic leukemia. Statistical Analysis Used: The collected data were analyzed using the Statistical Package for Social Sciences for Windows software, version 16 (SPSS Inc., Chicago, Illinois, USA). Results: The study subjects (n = 96) comprised 61 males and 35 females whose age ranged from 18 months to 91 years (mean = 39.73, ±22.1). There were 79 adults and 17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The ocular manifestations of leukemia were significantly (P = 0.01467) more frequent in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct leukemic infiltration was seen in 8 (8.3%) subjects while secondary or indirect involvement due to anemia, thrombocytopenia, hyperviscosity, total body irradiation, and immunosuppression were seen in 42 (43.8%) subjects. Ocular changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children (P = 0.09460). Twenty‑eight males (28/61) 45.9% and 14/35 (40%) females had ocular manifestations (P = 0.2874). The ocular manifestations were significantly (P = 0.01158) more frequent in myeloid leukemias 32/61 (52.9%) than lymphoid leukemias 10/35 (28.6%). Conclusions: Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients. Ocular involvement is more often seen in adults, acute and myeloid leukemias. All the primary leukemic manifestations were seen in males. A periodic ophthalmic examination should be mandatory for all leukemic patients, as ocular changes are often picked up in asymptomatic patients.